Abstract
Prediabetes is a critical public health issue characterized by elevated blood sugar levels that are higher than normal but not high enough to qualify as diabetes. It affects a significant portion of the global population and often progresses to type 2 diabetes mellitus (T2DM) without intervention. The American Diabetes Association identifies prediabetes with specific glucose and hemoglobin A1c (HbA1c) thresholds, emphasizing the necessity for effective management strategies to prevent the onset of T2DM. Low-carbohydrate diets, defined as those with carbohydrate intake below 130 g per day, have gained attention for their potential to improve glycemic control, reduce insulin resistance, and promote weight loss. While these diets show promising results, questions remain regarding their short- and long-term efficacy, sustainability, and associated risks. This review evaluated the short-term (≤6 months) and long-term (>6 months) effects of low-carbohydrate diets on glycemic control in prediabetic patients. It synthesizes current evidence on their impact on HbA1c, fasting glucose levels, insulin sensitivity, and metabolic adaptations. The findings revealed that short-term low-carbohydrate interventions consistently improve markers such as HbA1c, fasting glucose, and insulin sensitivity. In the long term, these diets can sustain these benefits and contribute positively to weight management and metabolic health. However, challenges such as dietary adherence, the potential for nutrient deficiencies, and the risk of reverting to pre-intervention glycemic levels upon discontinuation highlighted the need for personalized dietary planning and ongoing patient education. With careful implementation and monitoring, low-carbohydrate diets offer a promising approach to managing prediabetes and reducing the progression to T2DM.

Key words: Prediabetes, low-carbohydrate diets, glycemic control, effects, systemic review